WORKBOOK FOR INTRODUCTORY MEDICAL
NURSING 11TH EDITION ANSWERS KEY | ALL
CHAPTERS INCLUDED 2024/2025 (100% SOLVED) The major difference between illness
... [Show More] and disease is that illness is highly individual and
personal, whereas disease is something more definitive and measurable. For example, a client
with arthritis presents with distinct pathologic changes associated with the disease. A person,
however, may or may not be ill with arthritis. The degree of pain, suffering, and immobility
varies from person to person.
2. Health maintenance refers to protecting one’s current level of health by preventing illness or
deterioration, such as by complying with medication regimens, being screened for diseases
such as breast cancer or colon cancer, or practicing safe sex. Health promotion refers to
engaging in strategies to enhance health such as eating a diet high in grains and complex
carbohydrates, exercising regularly, balancing work with leisure activities, and practicing
stress-reduction techniques.
3. Medicare covers individuals who are 65 years or older, permanently disabled workers of any
age with specific disabilities, and persons with end-stage renal disease.
4. The team includes physicians, nurses, psychologists, pharmacists, dietitians, social workers,
respiratory and physical therapists, occupational therapists, nursing assistants, technicians,
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and insurance company staff. All members of this team collaborate on client issues (medical,
social, and financial) to achieve the best possible outcomes.
5. Groups such as children, older adults, ethnic minorities, and the poor are most likely to be
underserved by the healthcare system.
Activity E
1. Point-of-service (POS) organizations involve a network of providers. Clients select a primary
care physician within the group who then serves as the gatekeeper for other healthcare
services. Clients can use healthcare providers in or out of the provider group, but may pay
additional fees, such as a higher deductible or copayment, for providers outside the group,
unless the primary physician approves.
2. Clients select a primary care physician within the group who then serves as the gatekeeper
for other healthcare services. As with other types of managed care organizations, the focus is
on prevention as the best way to manage healthcare costs.
3. Benefits for the insurer include discounted services, reduced services, and elimination of
unnecessary referrals (Chitty & Black, 2011).
4. All are types of managed care networks. They provide a number of services within the
network at a controlled cost. All provide incentive to stay within the network by providing
lower cost services. Seeking services outside each of the organizations would incur higher
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costs for the client with the exception of the point-of service (POS) plan, which allows it if
approved by the primary care physician who serves as the gatekeeper. The goal of all the
organizations (POS, PPO, and PHO) is to maintain high-quality service and contain costs.
SECTION 2: APPLYING YOUR KNOWLEDGE
Activity F
1. Members of an HMO must receive authorization (referral) for secondary care, such as second
opinions from specialists or diagnostic testing. If members obtain unauthorized care, they are
responsible for the entire bill. In this way, HMOs serve as gatekeepers for healthcare
services.
2. Some individuals delay seeking early treatment for their health problems because they cannot
afford to pay for services. When an illness becomes so severe that the only choice is to seek
medical attention, many turn to their local hospital emergency departments for primary care.
This expensive alternative usually involves long waits and no follow-up care.
3. Possible premature discharge of clients and increased responsibility for family members who
may be unable to provide adequate care creates much criticism of the prospective payment
system. These systems have also caused shifts in costs from clients with Medicare to those
who have private insurance. Providers charge privately insured clients inflated amounts to
make up for losses in Medicare revenues.
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Activity G
1. Demand for evidence that hospitals and practitioners provide high-quality, cost-effective care
comes from insurers, regulatory bodies such as The Joint Commission, and consumers. One
example of standardized indicators are the quality indicators (QIs) provided by the Agency
for Healthcare Research and Quality (AHRQ). These QIs can be used to measure healthcare
quality at the federal, state, and local levels. The Joint Commission has also established
National Patient Safety Goals (NPSGs), which are updated annually. Multidisciplinary teams
use clinical pathways or care mapping for specific diagnoses or procedures, which
standardize important aspects of care. Many other methods exist for determining quality of
care. Patient satisfaction surveys, quality-of-life questionnaires, functional assessment tools,
number of hospital admissions per year for clients with chronic illnesses, and morbidity
(complications) and mortality (deaths) rates are a few important measures assessed when
examining quality.
2. Managed care involves insurers who carefully plan and closely supervise the distribution of
healthcare services. The goals of managed care include the following:
(i) Use healthcare resources efficiently.
(ii) Deliver high-quality care at a reasonable cost.
(iii) Measure, monitor, and manage fiscal and client outcomes.
(iv) Prevent illness through screening and health promotion activities.
(v) Provide client education to decrease the risk of the disease.
(vi) Case-manage clients with chronic illnesses to minimize number of hospitalizations.
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3. In an attempt to reduce redundancy of healthcare services and increase economic leverage,
hospitals and other healthcare facilities are forming networks known as integrated delivery
systems. Fully integrated healthcare delivery systems provide the following:
(i) Wellness programs
(ii) Preventive care
(iii) Ambulatory care
(iv) Outpatient diagnostic and laboratory services
(v) Emergency care
(vi) General and tertiary hospital services
(vii) Rehabilitation
(viii) Long-term care
(ix) Assisted living facilities
(x) Psychiatric care
(xi) Home healthcare services
(xii) Hospice care
(xii) Outpatient pharmacies
4. Illness prevention involves identifying risk factors such as a family history of hypertension or
diabetes and reducing the effects of risk factors on one’s health. Early detection uses
screening diagnostic tests and procedures to identify a disease process earlier, so that
treatment may be initiated earlier and be more effective. Examples include mammography
and colonoscopy.
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Activity H What do you think?
Activity I
1. A sign is the objective manifestation of a disease—something that can be seen, heard,
measured, or felt. A symptom is a subjective manifestation of a disease or illness—the
experience the client describes. One sign the nurse observed was that the client was
overweight at 196 lb. The client’s laboratory test results were also signs that indicated
measured characteristics of her blood. Another sign was the client’s previous experience with
gestational diabetes. The symptoms the client was experiencing were fatigue, frequent thirst,
frequent urination, and increased appetite.
2. See Figure 1-1 in Chapter 1 of the text for an example of the health-illness continuum. The
client is determined to stay active and healthy to reduce the possibility of future
complications. She is practicing health maintenance while focusing on illness prevention.
The client perceives herself in the normal to good health range on the continuum.
3. The nurse practitioner took time to address the physical problems the client was experiencing
while trying to put her at ease by answering her questions, encouraging her, and planning a
course of action with the client’s input and understanding. The nurse also made arrangements
for follow-up care and arranged for services through the network for diabetes education
classes and equipment. Holism means viewing a person’s health as a balance of body, mind,
and spirit and considering a client’s psychological, sociocultural, developmental, and
spiritual needs. The nurse did so in this example by providing information, encouragement,
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equipment, and other resources that went beyond simply addressing the client’s physical
needs.
4. A preferred provider organization (PPO) operates on the principle that competition can
control costs. Acting as agents for health insurance companies, PPOs create a community
network of providers who are willing to discount their fees for service in exchange for a
steady stream of referred customers. By providing the client with the tools she needs to
manage her diabetes, the PPO helps to control costs and decreases the possibility of any
future illness or hospitalizations. Consumers can lower their healthcare costs if the received
care is from the preferred providers. Keeping the client healthy not only decreases her risk
for future illness or hospitalizations but also adds to her quality of life.
SECTION 3: GETTING READY FOR NCLEX
Activity J
1.
*Answer: 3
Rationale: Nurses practice from the perspective of holism, which means that they view a
person’s health as a balance of body, mind, and spirit. Treating only a person’s physical needs
will not necessarily restore them to optimal health. Therefore, the nurse must also look at a
person’s psychological, sociocultural, developmental, and spiritual needs. Option 1 does not
include a client’s spiritual or sociocultural needs. Option 2 does not include the physical needs of
a client. Option 3 is correct because it includes all of the client’s needs. Option 4 is incorrect
because it does not include the psychological and sociocultural needs. [Show Less]